Headlines about "Medicare and Medicaid"
Gathered from the web by the editors at BenefitsLink.com.
Pressure Mounts for Special Process in Congress to Address Federal Debt, Including Health Care and Retirement Entitlements
Excerpt: "Noting that the regular order in Congress will not be able to deal with the increasing federal debt load, which is driven largely by entitlement programs such as Social Security and Medicare, Senate Budget Committee chair Kent Conrad (N.D.) concluded in a committee hearing on November 10 that a 'special process' is needed to compel legislators to fix the nation's fiscal problems." (Wolters Kluwer)
Aging and Health: The Challenges of Entitlement Growth (PDF)
November 2009. CBO Director Doug Elmendorf's presentation to the Association for Public Policy Analysis and Management. 16 pages. (U.S. Congressional Budget Office)
A Step-by-Step Guide to the Medicare 2010 Drug Plan Finder
Excerpt: "Looking for a Medicare Part D drug plan that will cost you the least in 2010 and cover all or most of your prescription drugs? This guide provides a direct route to that information by taking you step by step through Medicare's Prescription Drug Plan Finder, a useful online tool that allows you to compare many drug plans head to head to find your best deal. The plan finder does the math for you, so that you can see your likely out-of-pocket costs -- premium, deductible and copays for the specific drugs you use -- throughout the year." (AARP)
Medicare Part D and the Financial Protection of the Elderly
Excerpt: "We examine the impact of the expansion of public prescription prescription-drug insurance coverage from Medicare Part D has had on the elderly and find evidence of substantial crowd-out. Using detailed data from the 2002-6 waves of the Medical Expenditure Panel Survey (MEPS), we estimate that the extension of Part D benefits resulted in 75% crowd-out of prescription drug insurance coverage and 33%-50% crowd-out of prescription drug expenditures of those 65 and older. Part D is associated with relatively small reductions in out-of-pocket spending. This suggests that the welfare gain from protecting the elderly from out-of-pocket spending risk through Part D has been small." (Center for Retirement Research at Boston College)
[Guidance Overview] 2010 Medicare Premiums, Deductibles and Coinsurance
Excerpt: "Plan sponsors that pay the Medicare Part B premium or deductible should carefully review their plan documents and communications to assure that they are accurately stating the amount that the plan intends to pay. For example, plans that simply promise to pay the 'Part B deductible' may want to set that payment at a firm amount or maximum. If the plan is vague regarding the amount of the Part B premium that the plan will pay, costs could inadvertently increase as the Part B premium rises, and could rise substantially if the plan has participants subject to income-based indexing." (The Segal Group, Inc.)
[Guidance Overview] Medicare Part D Notices to Eligible Individuals Due Nov. 15 (PDF)
14 pages. Includes links to Model Individual Creditable Coverage Disclosure Notice and Model Individual Non-Creditable Coverage Disclosure Notice to be used in 2009. (Warner Norcross & Judd)
CMS Issues 2010 Medicare Premium, Deductible and Coinsurance Amounts
Excerpt: "The Centers for Medicare and Medicaid Services has released 2010 premiums, deductibles and other cost-sharing amounts for Medicare Parts A and B. The standard Part B monthly premium increases to $110.50, and the annual Part B deductible increases to $155. The Part A deductible will increase to $1,100 in 2010, while daily hospital cost-sharing amounts will increase by $8 or $16, depending on length of stay. However, a rarely applied rule will keep premiums the same for nearly three-quarters of recipients." (Mercer LLC)
[Guidance Overview] Remember to Distribute Annual Medicare Part D Notices by November 15, 2009
Excerpt: "Just a reminder that it's time once again to make sure that you have distributed the Notice of Creditable Coverage required under Medicare Part D, which informs participants whether the prescription drug coverage offered under your health plan constitutes creditable or noncreditable coverage. Once again, the Centers for Medicare and Medicaid Services (CMS) has issued updated forms that you may use to provide this notice. Employers who sponsor a health plan offering prescription drug benefits must provide an annual notice to all Medicare-eligible participants that explains whether the prescription drug benefits offered under the plan are at least as good as the benefits offered under the Medicare Part D plan. The only employers exempt from this notice requirement are those that establish their own Part D plan or who contract with a Part D plan." (Warner Norcross & Judd LLP)
[Guidance Overview] CMS Proposes Policy and Technical Changes to Medicare Part D Regulations, Including COB and MSP Provisions
Excerpt: "CMS has proposed policy and technical changes to the regulations for the Medicare Part D program that are intended to clarify participation requirements, strengthen beneficiary protections, improve payment rules, and implement new policy. As discussed below, some of the proposed changes affect group health plan sponsors that provide prescription drug coverage for Part D eligible individuals (including active employees, disabled employees, COBRA participants, retirees, and their covered spouses and dependents). In particular, changes have been proposed to the regulations on MSP procedures for coordination of benefits (COB) between Part D plans and other providers of prescription drug coverage (including group health plan sponsors). For example, the regulations would include a requirement for Part D plans to report credible new or changed primary payer information to the CMS Coordination of Benefits Contractor." (Employee Benefits Institute of America)
[Guidance Overview] 2010 Cost-of-Living Adjustments for Medicare (PDF)
2 pages. Note the paragraph on page 2 regarding employer action to be taken. (Milliman)
[Guidance Overview] Key 2010 Medicare Values (PDF)
2 pages. Excerpt: "This For Your Information provides key 2010 Medicare values just released by the Centers for Medicare and Medicaid Services, including the income-adjusted Medicare Part B premiums as prescribed by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA)." (Buck Consultants)
Basic Medicare Premium to Rise 15% Next Year
Excerpt: "The basic Medicare premium will shoot up next year by 15 percent, to $110.50 a month, federal officials said Monday. The increase means that monthly premiums would top $100 for the first time, a stark indication of the rise in medical costs that is driving the debate in Congress about a broad overhaul of the health care system." (The New York Times; free registration required)
[Opinion] What Exactly Does It Mean to Finance Retirement?
Excerpt: "Let's talk really macro policy for a bit. 401(k) plans and DB plans are (private) vehicles for financing retirement income. Social Security is a public vehicle for the same purpose. So, in fact, is Medicare. As people age, medical costs make up a greater and greater share of the cost of living. For many, in the end, medical costs are all you spend money on. So, one pretty useful way to think about Medicare is as another (public) vehicle for financing retirement." (PLANSPONSOR.com; free registration required)
[Guidance Overview] Chart of 415, Etc., Limits Updated for News Release IR-2009-94
The chart of maximum limits subject to inflation indexing at Carol V. Calhoun's employee benefits site has now been amended to include the newly announced 2010 limits. Among other things, the chart shows limits under sections 415, 403(b), 401(k), and 457, as well as the Social Security wage base and Social Security and Medicare tax rates, for 1996-2010. (Calhoun Law Group, P.C.)
Regulation of Private Health Insurance Markets: Lessons from Enrollment, Plan Type Choice, and Adverse Selection in Medicare Part D
Excerpt: "We study the Medicare Part D prescription drug insurance program as a bellwether for designs of private, non-mandatory health insurance markets that control adverse selection and assure adequate access and coverage. We model Part D enrollment and plan choice assuming a discrete dynamic decision process that maximizes life-cycle expected utility, and perform counterfactual policy simulations of the effect of market design on participation and plan viability. Our model correctly predicts high Part D enrollment rates among the currently healthy, but also strong adverse selection in choice of level of coverage. We analyze alternative designs that preserve plan variety." (National Bureau of Economic Research; paid subscription or individual purchase required to retrieve fulltext)
Medicare Bite Tied to Roth Would Be Temporary
Excerpt: "Yes, converting to a Roth could result in paying higher Medicare premiums, but the increase will likely be temporary. The key: If you are a Medicare beneficiary, or about to become one, it is smart to calculate whether the additional income created by a conversion could increase your Part B premiums, as well as your tax bill. Then, with that information in hand, you can make an informed decision about whether a Roth conversion makes sense for you." (The Wall Street Journal)
[Guidance Overview] CMS's Proposed Changes in Disclosure to CMS Form Instructions and Revises Guidance on Disclosure to Part D Eligible Individuals
Excerpt: "EBIA Comment: The changes to the creditable coverage disclosure items . . . are merely clarifying, not substantive. But those who are responsible for providing the required disclosures to CMS and to Medicare Part D eligible individuals should pay attention to these changes. The deletion of the mail-order provision is welcome. Since plans are not required to offer mail-order prescription drug coverage to meet the safe harbor, CMS may have dropped that provision just to avoid confusion. Having clarity in the safe harbor requirements is important: Plans that do not meet those requirements must make an actuarial determination of whether their prescription drug coverage is creditable." (Employee Benefits Institute of America)
[Opinion] 'Mini Medicare' Reform Could Cut Retirement Health Benefit Costs for Public Workers
Excerpt: "Today's Medicare benefits are unaffordable and unsustainable. To achieve actuarial balance, we need to both raise the payroll tax and raise the eligibility age for those we subsidize. Both reforms are achievable and must be joined at the hip to receive bipartisan support -- while at the same time providing a competitive alternative in the health insurance marketplace that 'bends the cost curve' and thus reduces state and local government retiree health care costs." (Governing.com)
[Guidance Overview] Deadline for Medicare Part D Creditable Coverage Notices Approaches (PDF)
2 pages. Excerpt: "Medicare Part D notices of creditable or non-creditable coverage must be provided to Medicare-eligible individuals prior to November 15 of each year. Many employers satisfy this requirement by including the notice in enrollment materials or in separate mailings in the fall. In preparing materials for distribution this fall, employers should be aware of revised model notices provided by the Centers for Medicare & Medicaid Services (CMS)." (Buck Consultants)
[Guidance Overview] Compliance with Mandatory Reporting Requirements Under Medicare, Medicaid and SCHIP Extension Act of 2007 (PDF)
Excerpt: "The Medicare, Medicaid and SCHIP Extension Act of 2007 ('MMSEA') took effect July 1, 2009. One of the purposes of MMSEA is to allow the federal government to recover payments made under Medicare when Medicareincorrectly acted as a primary payer or when a Medicare beneficiary receives payments from both an insurer and Medicare for the same injury. To that end, MMSEA requires group health plan arrangements ('GHPs' ) and liability insurers, no-fault insurers, workers' compensation insurers, and self-insurers (collectively, 'non-GHPs') to report any settlement, award, judgment, or other payment that they make involving a Medicare beneficiary to the Centers for Medicare and Medicaid Services ('CMS'), the federal agency within the U.S. Department of Health and Human Services that is responsible for administering Medicare." (Porter Wright Morris & Arthur LLP)
[Guidance Overview] CMS Revises HICN/SSN Collection Form Used for Mandatory Reporting Purposes
Excerpt: "EBIA Comment: Issuance of the revised guidance highlights CMS's commitment to getting the HICN/SSNs. Most of the changes were likely intended to make it easier for [responsible reporting entities (RREs)], active covered individuals, their spouses and family members to provide CMS with the necessary information. It is not clear why the reference to 'parent' was dropped from the revised guidance. Since the term had previously appeared in some categories but not others, the deletion may have been for reasons of consistency and not substance. But Medicare regulations do provide that 'family members may include a spouse (including a divorced or common-law spouse), a natural, adopted, foster, or stepchild, a parent, or a sibling.'" (Employee Benefits Institute of America)
2010 Medicare Part D Retiree Drug Subsidy Application Deadline Is Coming Soon
Excerpt: "Sponsors of calendar-year retiree medical plans must submit applications by Oct. 2 to obtain the Medicare Part D retiree drug subsidy (RDS) during 2010. RDS applications with valid initial retiree lists are due 90 days before a plan year begins, although sponsors can request an automatic 30-day extension. Even sponsors that previously received the subsidy must reapply each year. This year, attesting actuaries also must register anew, supplying birth dates and Social Security numbers as well as their American Academy of Actuaries membership numbers." (Mercer LLC)
New Enrollees and High-Income Retirees Will Soon Face Higher Medicare Premiums
Excerpt: "About 75 percent of people will be protected from the premium increase . . . . The remaining 25 percent of Medicare recipients will face larger than normal premium increases because the costs are spread across a smaller share of beneficiaries." (US News & World Report)
The Precarious Promise of Post-Employment Health Benefits
Excerpt: "This article examines the increasingly troubled state of employer-provided health benefits for retirees. The availability of such benefits is a major determinant of both the timing of retirement and the financial security of those who retire. Despite the signal importance of these benefits to current and prospective retirees, employers have been steadily eroding their value and in many cases, eliminating these benefits outright. Such actions are often catastrophic for the retirees affected, especially if they are not yet eligible for Medicare. This article begins by explaining the economic pressures that have precipitated this unfortunate development, including the increasing cost of health care generally." (Social Science Research Network)
[Guidance Overview] MSP Rules Prohibit Terminating Group Health Plan Coverage Based Solely on ESRD Eligibility, Except as Permitted by COBRA
Excerpt: "EBIA Comment: This case reminds us that the rules regarding Medicare eligibility and entitlement (including those for ESRD) are detailed and complex. It highlights that the rule prohibiting termination of group health plan coverage because of ESRD Medicare eligibility or entitlement does not prohibit termination of COBRA when termination of such coverage is expressly permitted (e.g., upon entitlement to Medicare)." (Employee Benefits Institute of America)
Centers for Medicare & Medicaid Services Announcement of Medicare Part D Premium Amounts for 2010
Excerpt: "The national average Part D premium for Medicare prescription drug coverage will reach $31.94 in 2010, up from $30.36 per month in 2009, CMS estimates. Employers applying for the retiree drug subsidy use this figure when determining the actuarial equivalence of their benefits. Part D beneficiaries will pay an average monthly premium of $30 in 2010, up from $28 in 2009. Other 2009 Part D figures released by CMS supply national average monthly bid amounts for stand-alone and Medicare Advantage (MA) plans offering prescription drug benefits, low-income subsidy amounts and MA benchmarks." (Mercer LLC)
[Guidance Overview] Broad Medicare Secondary Payer Reporting Rules Mean Additional Data Collection
Excerpt: "The Medicare Secondary Payer program seeks to ensure that Medicare isn't the primary payer of medical claims for beneficiaries also covered by group health plans. Mandatory reporting to Medicare of most group health plan participants' information began this year. Although insurers and third-party administrators are mainly responsible for the reporting, employers may need to collect some information, such as dependent Social Security numbers, from health plan enrollees. This Update provides an overview of the requirements and information employers may need to collect." (Mercer LLC)
The Implications of Declining Retiree Health Insurance
Excerpt: "Using data from the Health and Retirement Study, this paper examines the potential consequences of eliminating RHI for both pre-Medicare and Medicare-eligible retirees. For younger retirees the likely primary response is to work longer, and we find that number of workers age 55 to 64 would increase by 7 percent, as some of those who have their access to RHI eliminated would work rather than retire. Of those who still choose to retire, most lack any employer-sponsored health insurance option and would need to find an alternative source of coverage or go uninsured. For Medicare beneficiaries over 65, we estimate that about three quarters would replace RHI with another form of supplemental coverage. This shift would slightly reduce total spending and utilization for individuals who choose basic Medicare or a Medicare HMO as opposed to a Medigap plan, but health outcomes would probably be unaffected no matter which supplemental option is chosen." (Center for Retirement Research at Boston College)
[Opinion] U.S. Social Insurance Needs Rethinking
Excerpt: "The U.S. is headed for a fiscal meltdown. Even before Congress began calling for a hugely expensive overhaul of health care, the federal government was a staggering $56 trillion in the hole, in terms of unfunded obligations. That's $184,000 of debt for every American. Even after its tax increases, the House health bill would add an additional $10 trillion in red ink. No wonder foreign investors as well as ordinary Americans are beginning to worry we won't be able to pay our national bills." (Stuart Butler via The Washington Times)
[Guidance Overview] New Audit Guide for Medicare Advantage and Part D Programs Released for Comment
Excerpt: "In its proposed collection and comment request published in the Federal Register on Friday, July 31, 2009, CMS announced the merger of the existing Part C and Part D audit guides into a single Medicare Part C and Part D Universal Audit Guide. Currently available in draft form, the universal audit guide reflects streamlined data elements, uniform language, and omits duplicative data elements as well as previously deleted items. The information collection and comment request also includes a draft audit confirmation letter; minimum documentation requirements for sample case files; and the accompanying 'universe request' for data for Medicare Advantage and Part D Plan audits." (McDermott Will & Emery)
[Guidance Overview] Medicare Reporting Applies to Uninsured Liability Claims: Employers May Be Required to Register
Excerpt: "The Medicare, Medicaid and SCHIP Extension Act of 2007 ('MMSEA') implements new mandatory reporting requirements (referred to as 'Section 111 Reporting') to allow Medicare to identify medical claims where another entity, not Medicare, is responsible for payment pursuant to the Medicare Secondary Payor rules. Most employers, administrators and insurers are aware of how these reporting requirements apply to group health plans, which began July 1, 2009 (except for health reimbursement arrangements which are delayed until 2010). The Section 111 Reporting requirements also apply to workers' compensation claims and to liability insurance (referred to as 'Non-GHP Arrangements'). Registration for Non-GHP Arrangements must be completed by September 30, 2009 and reporting begins in 2010. However, the Section 111 Reporting requirements are structured to incorporate arrangements and situations which employers do not typically view as implicating Medicare. The focus of this Legal Alert is to highlight the impact of the Section 111 Reporting on these arrangements." (Kilpatrick Stockton LLP)
[Guidance Overview] Medicare Secondary Payer Reporting Requirements Spur Requests for Dependent Social Security Numbers (PDF)
3 pages. Excerpt: "The new reporting mandate under the Medicare, Medicaid and SCHIP Extension Act of 2007 will require group health plan 'responsible reporting entities' (RREs) to submit the Social Security numbers of many employees' covered dependents to the CMS coordination of benefits contractor by October 1, 2009. Although employers are generally not RREs, they may be asked by the RRE to help obtain that information." (Buck Consultants)
Medicare Part D Update : Lessons Learned and Unfinished Business
Excerpt: "Enacted in 2003, Medicare's Part D prescription drug benefit reflected an unprecedented and controversial new approach for Medicare, relying exclusively on private plans to provide health coverage and including an unusual gap in coverage. This analysis by Kaiser researchers examines in detail how the new model has worked since its launch almost four years ago. Published as an article in today's New England Journal of Medicine, the analysis by Kaiser vice president Patricia Neuman and principal policy analyst Juliette Cubanski assesses the evidence related to key policy questions arising from the Part D benefit. It also briefly discusses a number of potential policy changes to the Part D benefit that could arise as Congress and the Obama Administration weigh the program's future." (Kaiser Family Foundation)
[Guidance Overview] Recent Legislation and Regulations Require Changes to Health and Welfare Benefit Plans
Excerpt: "Congress and federal regulatory agencies have been busy enacting legislation and proffering guidance which implements many new requirements for group health and welfare benefit plans. Many of the changes will require thoughtful action on the part of administrators and sponsors of group health and welfare benefit plans. This brief outline of current health and welfare compliance developments is not intended to be exhaustive, but rather serves to illustrate the depth and breadth of changes facing plan sponsors now and in the coming months." (Littler Mendelson P.C.)
GAO Testimony: Overview of Approaches to Control Prescription Drug Spending in Federal Programs
June 24, 2009. 16 pages. Testimony given by John E. Dicken, director, health care, before the Subcommittee on Federal Workforce, Postal Service, and the District of Columbia, House Committee on Oversight and Government Reform. (U.S. Government Accountability Office)
Obama To Formally Announce Medicare Drug Costs Cuts Today
Excerpt: "The pharmaceutical industry agreed Saturday to reduce Medicare drug costs as part of health overhaul in an apparent effort to stave off potentially more-burdensome givebacks under the Democrats' health-overhaul plan. Today, President Barack Obama will make a formal announcement about the deal. The Wall Street Journal reports: 'Drug makers on Saturday outlined a proposal to forgo $80 billion in revenue over a decade, largely by covering more of the cost of brand-name prescription drugs under the federal government program for seniors. It would make up part of the $313 billion in government health-spending cuts that President Barack Obama has proposed over a decade to help pay for the overhaul plan.'" (Kaiser Family Foundation)
[Guidance Overview] CMS Update on Mandatory Insurer Reporting User Guide and Other Guidance
Excerpt: "This Capital Checkup summarizes key issues addressed in the updated guidance: New registration deadline for entities reporting only on Health Reimbursement Arrangements (HRAs), What it means for a person to be 'known to be entitled to Medicare'), and CMS's recommended process for collecting Medicare Health Insurance Claim Numbers (HICNs) or Social Security Numbers (SSNs)." (The Segal Group, Inc.)
Savings Needed for Health Expenses in Retirement: An Examination of Persons Ages 55 and 65 in 2009 (PDF)
Pages of 20 pages. Excerpt: "This report updates earlier EBRI research on estimated savings needed to cover health insurance to supplement Medicare and out-of-pocket expenses for health care services in retirement. It finds that men age 65 in 2009 retiring this year will need anywhere from $68,000?$173,000 in savings to cover health insurance premiums and out-of-pocket expenses in retirement if they want a 50?50 chance of being able to have enough money, and $134,000?$378,000 if they prefer a 90 percent chance. With their greater longevity, women will need more: a women retiring at age 65 in 2009 will need anywhere from $98,000?$242,000 in savings to cover health insurance premiums and out-of-pocket expenses inretirement for a 50?50 chance of having enough money, and $164,000?$450,000 for a 90 percent chance." (Employee Benefit Research Institute)
Medicare Beneficiaries' Out-of-Pocket Spending for Health Care Services
Excerpt: "Beneficiaries spent an average of $4,394 of their own money on health care services in 2005 -- about 28 percent of income." (AARP)
Medicare Secondary Payer User Guide Updated With Guidance for Responsible Reporting Entities and Group Health Plans
Excerpt: "EBIA Comment: ['Responsible reporting entities'] will likely welcome any assistance to deal with the thorny problem of collecting [Medicare Health Insurance Claim Number]/SSNs. It remains to be seen, of course, whether the new strategy will result in a higher level of cooperation from subscribers and their dependents. Collecting information about dependents is particularly difficult since information about them is harder to obtain and often less accurate than for subscribers. " (Employee Benefits Institute of America)
How The White House Hopes to Control Health Care Costs
Excerpt: "Senate sources confirm that the president argued in favor of a genuinely major Medicare reform -- a reform that could make Medicare the nation's most important laboratory for health care reforms." (Washington Post; free registration required)
CMS Announces 2010 Indexed Medicare Rx Amounts
Excerpt: "Recently announced 2010 limits for Medicare Part D prescription drug benefits reflect annual adjustments that affect employers' calculations when applying for the retiree drug subsidy (RDS). Upcoming changes to the RDS application process will require actuaries to register again with additional identifying information and revise how lists of covered retirees are submitted and processed. The latest update to the RDS User's Guide includes a chapter on the appeals process." (Mercer LLC)
A Summary of the 2009 Annual Reports from the Social Security and Medicare Boards of Trustees
Excerpt: "Each year the Trustees of the Social Security and Medicare trust funds report on the current and projected financial status of the two programs. This message summarizes our 2009 Annual Reports." (U.S. Social Security Administration)
Recession Drains Social Security and Medicare
Excerpt: "[The administration said that] the Medicare fund that pays hospital bills for older Americans is expected to run out of money in 2017, two years sooner than projected last year. The Social Security trust fund will be exhausted in 2037, four years earlier than predicted, it said." (The New York Times; free registration required)
2009 Medicare Trustees Report
Excerpt: "The Boards of Trustees for Medicare . . . report annually to the Congress on the financial operations and actuarial status of the program. Beginning in 2002, there is one combined report discussing both the Hospital Insurance program (Medicare Part A) and the Supplementary Medical Insurance program (Medicare Part B and Prescription Drug Coverage). . . . The Boards of Trustees issued their most recent report on May 12, 2009." (Boards of Trustees of the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund via Centers for Medicare & Medicaid Services)
How Do Medicare and Employer Coverage Compare in Meeting Enrollees' Needs?
Excerpt: "One key issue in health reform concerns the relative roles of coverage offered through private insurance and public programs. This paper compares the experiences of aged Medicare beneficiaries with those of people under age sixty-five who have private employer coverage. Compared with the employer-coverage group, people in the Medicare group report fewer problems obtaining medical care, less financial hardship due to medical bills, and higher overall satisfaction with their coverage. Although access and bill payment problems increased across the board from 2001 to 2007, the gap between Medicare and private employer coverage widened." (Health Affairs)
Annual Checkup for Social Security and Medicare
Excerpt: "The financial health of the government's two biggest benefit programs may have slipped over the past year, reflecting the deep recession that has already bitten into other areas of the budget. The trustees for Social Security and Medicare are scheduled to provide their annual report on the finances of both programs on Tuesday. In advance of the release, many private analysts said they expected both programs could run out of cash sooner than last predicted." (AP via The New York Times; free registration required)
[Guidance Overview] Requiring Older, Medicare-Eligible Retirees to Pay Larger Portion of Premium Contribution Under Health Plan Did Not Violate ADEA
Excerpt: "EBIA Comment: There have been few decisions to date applying the 2007 final EEOC regulations regarding Medicare coordination. Although not completely clear, it appears that this court found the Medicare coordination regulations and the equal benefits/equal cost rule to be sufficient, independent grounds for dismissing the retirees' claims. While that may explain the court's limited analysis of the equal benefits/equal cost rule, it would have been helpful if the court had revealed more about why it thought benefits for older and younger retirees were considered equal, given the premium differences." (Employee Benefits Institute of America)
[Guidance Overview] July 1, 2009 Implementation for New Medicare Secondary Payer Reporting
Excerpt: "Group health plans that are not voluntarily sharing data with the Centers for Medicare & Medicaid Services (CMS) will need to confirm that they are able to comply with the new reporting requirements scheduled to go into effect beginning July 1. The responsible reporting entity is typically the plan's insurer or third party administrator ? however, where the plan is self-insured and self administered, the plan administrator or fiduciary is required to report. Specific data is required to enable CMS to verify that benefits are accurately being paid where the Medicare is a secondary payer." (Deloitte via BenefitsLink.com)
Medicare Poised to Take Bigger Chunk of Social Security Checks Next Year
Excerpt: "CBO estimates the basic premium will rise to $119 next year and to $123 in 2011 for those not protected by the law. In addition, the Times reports that millions of beneficiaries also could experience higher premiums for drug coverage under Medicare Part D because there are no laws that prevent such an increase." (California HealthCare Foundation)
[Guidance Overview] The Imminent New Mandatory Medicare Secondary Payer Reporting Rules (PDF)
5 pages. Excerpt: "We recommend the following steps for each provider of liability or no-fault insurance, workers' compensation programs or insurance, and each person who self-insures such risks, including TPAs: Become familiar with the MMSEA reporting requirements. Determine whether you are a Responsible Reporting Entity. Design a process to capture required information. Register online with the Medicare Coordination of Benefits Contractor before June 30, 2009. Begin testing." (Drinker Biddle Reath LLP)
8 Tips on Paying for Health Care in Retirement
Excerpt: "1. Don't count on employer benefits. Most current employees . . . won't be eligible for retiree health insurance through their former employer . . . . Less than a third of firms with 200 or more workers offered retiree health benefits in 2008, down from the 66 percent that did so in 1988, according to a Kaiser Family Foundation survey." (U.S. News & World Report via Chicago Tribune)
[Guidance Overview] CMS's Medicare Part D Benefit Parameters for 2010
Excerpt: "EBIA Comment: The new parameters will help group health plan sponsors determine whether their plans' prescription drug coverage is creditable for 2010. This information is needed for the disclosures that must be made annually and at other specified times to Part D eligible individuals and to CMS [Centers for Medicare & Medicaid Services]." (Employee Benefits Institute of America)
[Guidance Overview] New Medicare Secondary Payer Reporting Obligations for Workers' Compensation Plans
Excerpt: "Beginning July 1, 2009, many employers and insurance companies will be required to report claims for workers' compensation claimants that are also Medicare beneficiaries to the Centers for Medicare and Medicaid Services (CMS) and become subject to a $1,000 per day per claimant penalty for failure to comply with this mandatory reporting requirement." (Littler Mendelson P.C.)
[Guidance Overview] 2010 Medicare Part D Benefit Parameters (PDF)
2 pages. Excerpt: "The Centers for Medicare and Medicaid Services (CMS) has updated the Medicare Part D standard benefit parameters and the cost thresholds and limits for qualified retiree prescription drug plans for 2010." (Buck Consultants)
[Guidance Overview] CMS Revision of Indexed Medicare Part D Amounts for 2010, Updated April 8, 2009
Excerpt: "In an April 6, 2009 announcement, the Centers for Medicare & Medicaid Services (CMS) revised and made final the indexed Medicare Part D standard benefit and Retiree Drug Subsidy (RDS) amounts for 2010, previously announced in an advance notice. This Capital Checkup features charts comparing the final 2010 numbers and the 2009 numbers." (The Segal Group, Inc.)
[Guidance Overview] New Laws And Drafting Tips for Welfare Plans In 2009
52 slides from the firm's March 26 presentation. Excerpt: "Federal COBRA Premium Subsidy for Involuntary Terminations; Children's Health Insurance Program (CHIP) Reauthorization Act; Centers for Medicare and Medicaid (CMS) Reporting Changes; Drafting Tips: Strengthen Litigation Protections; Plan Statute of Limitations and Venue; Plan Definition of 'Spouse'." (Sidley Austin LLP)
CMS Issues Retiree Drug Subsidy User Guide and New FAQs
Excerpt: "Employers applying for the Medicare Part D retiree drug subsidy (RDS) now have additional resources on the RDS application and reconciliation process. CMS has issued a new RDS User Guide, which includes information from many how-to documents on its website. The agency also has released eight frequently asked questions addressing how to correct submitted drug costs, payment requests or retiree lists after an application has completed reconciliation." (Mercer LLC)
[Guidance Overview] CMS Update of Creditable Coverage Disclosure to CMS Form
Excerpt: "EBIA Comment: Happily, there are few changes to the Disclosure to CMS Form, and none of them are rocket science. Most seem aimed at fixing practical problems raised by how individuals were filling out the previous version of the Form." (Employee Benefits Institute of America)
House Takes Up a Plan Tied to Health Care Overhaul
Excerpt: "House Democrats pressed a budget plan Wednesday to make it easier to pass health care legislation backed by President Barack Obama, but their GOP rivals in the Senate preserved their ability to block upcoming legislation on global warming. As debate continued on nonbinding Democratic budget plans largely mimicking President Barack Obama's $3.6 trillion budget proposal, Republicans in the House offered an alternative that would eventually end the Medicare program as it is presently known." (AP via Yahoo! News)
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